Should ultrasound be a standard preoperative tool in surgical planning?

Ultrasonography has been used traditionally as an imaging technique for diagnosis and characterization of breast lesions. It has also been increasingly used in the initial staging of breast cancer. Review of the literature suggests that use of ultrasonography, in combination with fine needle aspiration, is an accurate means of staging the axilla, and advances in ultrasound technology have also improved the reliability of results obtained by use of this imaging modality. This review provides an overview of the utility of ultrasonography for assessing patients with breast diseases, with special emphasis on breast cancer and its evolving use in axillary assessment and staging. We also discuss the features of abnormal axillary ultrasound, the accuracy, reliability, and limitations of axillary ultrasound, and finally, the role of axillary ultrasound in the post-ACOSOG Z0011 era.